I'm not going to get into all of the launch plans, but what I will tell you is the team has got an aggressive agenda lined up, and they're completing all the other associated testing as we speak. Maybe a little bit more color there in terms of the sustainability of growth you see as we just think about that franchise evolving over time. Joe? We are truly proud of her recognition for this incredible work.Our commitment to diversity, equity, and inclusion in both our workforce and the communities in which we serve has always been an important part of our culture. Our Consumer Health segment yielded solid performance throughout the pandemic, resulting in above-market growth. Tasos Katopodis/Getty Images. And again, there were regions around the country where we saw a differential impact. [Operator instructions] And your first question is from Terence Flynn with Goldman Sachs. What I would say is we've been around for 135 years. Well, thank you, everyone, for your comments, for your questions, and for your ongoing interest, trust, and confidence in Johnson & Johnson. If it's determined that you do have MGD, you can proceed with receiving the 12-minute LipiFlow treatment. I would be remiss if I didn't acknowledge the tremendous efforts of healthcare providers around the world that have society in a much better place today with improved treatment protocols and resource allocation compared to the start of the pandemic. The decline is primarily related to COVID-19 impacts realized predominantly in our Medical Device business, along with increased R&D investment, including the investment associated with our COVID-19 vaccine candidate. A further description of these risks, uncertainties, and other factors can be found in our SEC filings, including our 2019 Form 10-K and subsequent Form 10-Qs, along with reconciliations of the non-GAAP financial measures utilized for today's discussion to the most comparable GAAP measures are also available at investor.jnj.com. Consumer margins improved by 430 basis points, primarily driven by portfolio and investment optimization, including execution of our SKU rationalization program. People may need an annual COVID-19 vaccination over the next several years, Johnson & Johnson CEO Alex Gorsky told CNBC during an interview on Tuesday. Learn more about the LipiFlow® Thermal Pulsation System, including safety information. As you heard from Ashley, Dr. Moll, and the team at the medical device update in November, we are developing an end-to-end digital ecosystem across three robotics platforms, and we achieved a significant milestone this month, receiving FDA clearance for our VELYS robotic-assisted solutions. Offsetting these declines was strong Adult TYLENOL market and share growth attributed to elevated demand driven by COVID-19, ZYRTEC share growth partially due to competitive out-of-stock, and strong market growth in anti-smoking aids in EMEA. And research just published in the journal Clinical Ophthalmology supports its effectiveness: The study showed that treatment with the device increased the average amount of time that contact lens wearers with MGD could comfortably wear their lenses by approximately four hours. Joe Wolk -- Executive Vice President and Chief Financial Officer. We expect that in '21. ERLEADA continued its strong growth momentum with sales of just over $240 million in the quarter, driven by market share and penetration gains, especially in the metastatic indication. “Both have a much lower blink rate,” explains Dr. Boorady. Wikipedia Is a Monopoly. "COVID-19 Inspired Me to Improve Patient Care": How Two Nurses Devised New Ways to Help Kids and Fellow Nurses During the Pandemic. Postmenopausal women are also at higher risk for MGD. I think in the near term, what we've learned is, frankly, the importance of innovation and science, and if you reflect back on where we were just 11 or 12 months ago at the beginning of COVID-19 and where we are now and the number not only of very innovative vaccine candidates but therapeutics and the differences that they made. Throughout 2020, we saw COVID-19-driven fluctuations, and most pronounced was the first quarter when, as we noted, we benefited from longer script durations. What we said from the very beginning is that we put a lot of work and thought and very strong science and review into the selection of our lead candidate. I wonder if you could just comment on, number one, when can we expect the dual-dose data? But I think it's fair to say that we were pleased to see the ability of the majority of systems in the United States be able to continue to provide elective procedures even in spite of some of the later surges. From a virtual reality game that helps children with remote physical therapy to a clever way to upgrade personal protective equipment for healthcare workers, the winning ideas from the latest Johnson & Johnson Nurses Innovate QuickFire Challenge came out of medical conundrums posed by the pandemic. While surgical vision declined 10.1% globally, this represents an improvement from Q3 where the business declined 16.4%, with the most notable improvement in the U.S. Our level of R&D investment reached an all-time high of $12.1 billion, $800 million more than our 2019 R&D investment. Let's now look at adjusted income before tax by segment. Worldwide Consumer Health sales totaled $3.6 billion and grew 2%, with growth in the U.S. of 2.7% and 1.5% outside of the U.S. Consumer Health delivered strong above-market growth due to our Oral Care, Wound Care, and OUS skin health/beauty businesses partially offset by the negative impact of COVID-19 primarily in our OTC business and the SKU rationalization program which predominantly impacted baby and skin health/beauty outside the U.S. E-commerce growth continues to be strong across regions and franchises. Your next question is from Danielle Antalffy with SVB Leerink. There's a lot of assumptions, a lot of dynamics that we'll have to watch closely. TREMFYA grew 39.3% and is up about 3 points of share from the fourth quarter of 2019 in the psoriasis market in the U.S. TREMFYA continues to strengthen its leadership position as the most prescribed IL-23 inhibitor for patients worldwide through its differentiated data package in both psoriasis and psoriatic arthritis. Starting with sales. Larry Biegelsen -- Wells Fargo Securities -- Analyst. U.S. contact lens declined 7.1%. But we would expect that to play out. We continue to actively evaluate external value-creating opportunities, but for purposes of your financial models, we are not assuming any major acquisitions or other major uses of cash at this time. Get the latest news and analysis in the stock market today, including national and world stock market news, business news, financial news and more This site uses cookies as described in our. Sales also declined in Europe, where some of the strictest restrictions were deployed to curb the increases in COVID-19 cases. Thanks, Alex. Alex Gorsky-- Chairman of the Board of Directors and Chief Executive Officer Hey, Bob, thank you very much. Thank you. Yes. Thirty million Americans suffer from Meibomian gland dysfunction, which causes the majority of dry eye cases. What we saw in North America in Q4 was it's down just about -- or excuse me, up … In regions outside the U.S., our reported year-over-year change was negative 1.3%. 2020 adjusted net earnings were $21.4 billion and adjusted diluted earnings per share was $8.03, representing decreases of 8.1% and 7.5%, respectively, versus full-year 2019. There are a lot of dynamics that we certainly saw in the past year in the contact lens market, significant contraction, as well as in the surgery market. Bob Hopkins -- Bank of America Merrill Lynch -- Analyst. We believe that our position overall in the contact lens has continued to strengthen, and we did see improvement as we went quarter to quarter and ended the year. While not predicting the impact of currency movements, assuming recent exchange rates, our reported adjusted EPS would be positively impacted by approximately $0.15 per share, resulting in adjusted reported earnings per share of $9.50 at the midpoint, reflecting growth of 18.3% versus the prior year. Just on 2021 device sales, can you just help us quantify or provide more color around how much of an impact COVID will still be having on sales versus what you consider to be, I guess, normalized levels? And as shareholders in Johnson & Johnson have come to expect, we continue to prioritize our dividend by announcing last April a 6.3% increase. Terence Flynn -- Goldman Sachs -- Analyst. As you heard during our medical device update in November, our core platforms continue to strengthen, driven by enhanced execution and improved cadence of innovation and filling critical portfolio gaps, including and most notably, advancing our future digital surgery offerings. As we continue to deal with some of the ongoing surge, we would expect the year-on-year comparisons to change pretty significantly in Q2 and Q3. You're right, it's a competitive market space, but we're seeing some switches out of STELARA to TREMFYA. At the start of last year, no one could have imagined just how drastically our lives were about to change because of a virus that would impact billions of people around the world. 2019 also includes approximately $2 billion related to the divestiture of the Advanced Sterilization Products business. AIX (Advanced Interactive eXecutive, pronounced / ˌ eɪ aɪ ˈ ɛ k s /) is a series of proprietary Unix operating systems developed and sold by IBM for several of its computer platforms. We anticipate the webcast will last up to 90 minutes. Operator, can you please provide instructions for those on the line wishing to ask a question? We continue to monitor and work with healthcare systems around the globe as they balance surges in COVID-19 cases with treatment for non-COVID-19 patients. The last question will be coming from Bob Hopkins with Bank of America. But again, we would expect to continue to see expansion over the course of 2021 and beyond that, again, see a return to a market that was growing in the mid-single digits previously, and we would expect that to continue going forward as well. This translated in returning $10.5 billion to investors in 2020, approximately 50% of our free cash flow. We think it's very important to follow the data, to follow the science. In October, Johnson & Johnson board director, Dr. Jennifer Doudna, along with her colleague, Dr.Emmanuelle Charpentier, was awarded the 2020 Nobel Prize in Chemistry for the revolutionary discovery of CRISPR/Cas9 gene-editing technology, considered to be one of the most significant breakthroughs in molecular biology in the past decade. Medical Devices declined by 900 basis points, driven by COVID-19 impacts on the business, including fixed cost deleveraging associated with sales declines. Is 70% a good floor? Some of those are starting to pay off in 2021 as well. But again, here, too, if we normalize out our trends for third and fourth quarter, we think that overall, those quarters were pretty consistent, down about 3.5% after you pull everything else out, and will put us on a good rate, as we mentioned earlier, over the course of 2021 and beyond. Eventually, if a Meibomian gland stays plugged up with that thick white stuff for long enough, it will die off, and your symptoms will grow even worse. This decline was primarily driven by the tax benefit associated with the fourth-quarter 2020 litigation expenses. Our R&D colleagues across Johnson & Johnson have continued to advance our robust pipeline of innovative and transformational new products. Our Race to Health Equity aims to help improve racial equity by eliminating health inequities for people of color and our $100 million commitment to invest in and promote health equity. Appreciate the question. So just curious if you could comment on the durability of your vaccine versus the other vaccines that are in development or at least your goals for durability. Joanne, regarding VELYS, look, we were very excited about the approval with the FDA. As consumers continue to focus on products related to personal health and hygiene, Oral Care grew by 12% on continued growth of LISTERINE mouthwash due to new flavor and product innovations and the increased demand globally related to COVID-19. Contact lens wearers are at higher risk, as are heavy users of electronic devices. We believe the industry is just starting to unlock the full potential and benefits of robotic and digital technologies. For the second half, we would anticipate more normalized growth as consumers return to more typical usage patterns for products in areas like skin health and beauty. This slide acknowledges those relationships. Excluding the net impact of acquisitions and divestitures, primarily the divestiture of ASP, adjusted operational sales decline was 1.5% worldwide. Interventional Solutions continue to demonstrate strong performance, delivering another quarter of double-digit growth. And I think Dr. Paul Stoffels and Dr. Mathai Mammen, once we have that, will be able to give a much more comprehensive review on exactly how we think our vaccine will work against the current strains and variants and our plans for the future. Please click below to continue to that site. In December, Johnson & Johnson appointed retired U.S. Army Lieutenant General and former U.S. Army Surgeon General, Dr. Nadja West, to our board of directors. Appreciate the question. Welcome to our company's review of business results for the fourth quarter and full year of 2020 and our financial outlook for 2021. Let's now turn to our full-year 2021 guidance. (VIA UAB) The Alabama Department of Public Health on Friday announced that beginning Feb. 8 the state will expand COVID-19 vaccinations to those aged 65 and older, and other frontline workers, including employees in the education sector, grocery store workers, postal workers, correctional officers and others. We estimate the negative impact from net acquisitions and divestitures of approximately 50 basis points and, as such, are comfortable with your models reflecting operational sales growth in the range of 7.5% to 9% or $88.8 billion to $90.0 billion. And I'm sorry if I missed this, Alex. Use of this site constitutes your consent to application of such laws and regulations and to our Privacy Policy. Great. Good morning. Alex Gorsky is a good friend, and we talk often on multiple topics—and so I raised this concern with him. I'll hand it over to Joe to take the second part of that question. I'm now pleased to turn the call over to Joe Wolk. As we have noted previously, healthcare systems continue to demonstrate their resiliency and dedication to treating both COVID-19 and non-COVID-19 patients, resulting in significantly less disruption during this recent surge of cases versus the impact seen earlier this year. My second quick one was just on STELARA. Hey, David, this is Alex. What we saw in North America in Q4 was it's down just about -- or excuse me, up about 2%. And as we've articulated a number of times, our goal is to grow at or faster than the markets where we compete. Just one quick one. Ashley McEvoy,Company Group Chairman, Johnson & Johnson Vision and Johnson & Johnson Diabetes Care Companies, Company Group Chairman, Johnson & Johnson Vision and Johnson & Johnson Diabetes Care Companies, who underwent LipiFlow herself. But our current plans would take those kind of projections into consideration. We do feel that the overall knee market will recover in 2021. You are now leaving jnj.com. We continue to invest in COVID-19 vaccine development impacting the first quarter while we pursue authorization. Rob, next question, please. Thank you very much. Over 30 million Americans suffer from MGD, a major cause of dry eyes. However, impacts varied across geographies and procedure types. TORONTO, Feb. 08, 2021 (GLOBE NEWSWIRE) -- CCL Industries Inc. (TSX:CCL.A) (TSX:CCL.B), a world leader in specialty label, security and packaging solutions for global corporations, government institutions, small businesses and consumers, will be releasing its Fourth Quarter and Year End 2020 results at 7:00 a.m. on Thursday, February 25, 2021, and will be holding a conference call … 4. It's likely an overused term at this point, but 2020 was a remarkable year on just so many different fronts. I encourage you to review our 10-K for further details on specific tax matters. Gorsky told CNBC the company was "extremely confident" that it will meet its target to deliver 100 million doses of its coronavirus vaccine to the United States by the end of June. One would just be just in general as you think about new variants in the marketplace and the need for a booster. Thank you. Given variability that occurred due primarily to COVID-related dynamics, this slide, while not to scale and meant to be illustrative, offers some perspectives on the quarterly phasing across our businesses. I will review the fourth-quarter sales and P&L results for the corporation and the three business segments. And we also have a Tecnis Synergy IOL, a first-in-class product combining a number of different technologies to really deliver a great range with high contrast. As reported earlier, our adjusted EPS of $1.86 reflects a reported decrease of 1.1% and an operational decrease of 3.2%. “You don't have to worry about any impact to your vision—you can drive and do all your usual activities,” says Dr. Boorady. Thanks so much for the questions. As Alex alluded to, there's still some fluidity with respect to timelines. And within Johnson & Johnson, it has illustrated the power and importance of our credo in guiding our actions to meet the needs of all our stakeholders. Regarding durability, again, we're going to have to see how some of the early data in some of the preclinical work that we have done plays out in the actual large-scale trials. Editor ranks are filled with people just like Tim1965. Your next question is from Matt Miksic with Credit Suisse. So those are perhaps some of the longer-term trends. Right now, I'll turn the call over to Chris to share details related to our performance for the quarter. Third, we've seen a rapid expansion in telehealth, and that's in primary care offices but also specialty offices. Our relentless focus on excellence and execution is key to meeting the needs of all our stakeholders today and tomorrow. Excluding the benefit of the additional shipping days, the U.S. declined low single digits due to COVID-19-related restrictions occurring late in the quarter. And what's really important to remember about STELARA is just the diversity of indications now that we have with that compound, especially in GI conditions, where we think it's particularly differentiated and unique, both in terms of its efficacy and now a very robust safety profile as well based upon the years of experience. Chris, look, overall, we remain very confident in the long-term prospects around the medical device market. Postmenopausal women are also at higher risk for MGD, as well as people with autoimmune disorders, like rheumatoid arthritis and lupus. As mentioned earlier, we observed instances of non-emergency procedure postponements late in the fourth quarter, but healthcare systems continue to meet the needs of both COVID and non-COVID patients resulting in less COVID-19 market disruption as we progressed through 2020. Thanks, Danielle. And I think we saw very good signs of that actually over the course of 2020, where we saw the medical device market drop anywhere from 30% to up to 70%, depending on which category you're looking at, to return to mid-single-digit drops in the third quarter as we went through the rest of the year. Looking geographically. And what are your thoughts about the booster relative to the mRNA-based platforms? ALEX GORSKY, chief executive of Johnson & Johnson Friedman is owed respect for his analysis, but this highlights the ways in which investors and society have evolved over 50 years. DARZALEX continued its strong performance, growing 49%, led by share gains globally, with the U.S. market share up about 4 points across all lines of therapy. We certainly want to keep the flexibility that we've had even during 2021 and all that uncertainty to continue to invest in innovative ideas that really fortify not just this year but well beyond. Stock Advisor launched in February of 2002. Offsetting this decline is the growth we continue to see from the success of recent launches of new products such as SYMPHONY and CONDUIT. The format and location will be announced at a later date, but we hope that you're able to join us for this event, where we look forward to sharing the details about our robust pipeline and differentiated capabilities that gives us the confidence in our ability to sustain growth in Pharmaceuticals at above-market levels. Worldwide orthopedics declined 5.3% versus prior year, driven by the negative impact of COVID-19 on procedures deemed to be more elective in nature. And hence, will we have any insight in terms of the vaccine efficacy against some of these new variants? I would say with respect to supply, consistent with the comments that were made earlier, we intend to meet all of the firm order commitments that we have, whether that be to the United States, to the European Union, or to developing countries through the Gavi organization. Regarding VELYS, as I mentioned earlier, we think it does offer a number of unique advantages. And expectations that companies can and should help drive positive change in the society are higher than ever. Therefore, although not linear, for the full year, we anticipate growing competitively with the markets in which we compete. On an operational basis, adjusted diluted earnings per share decreased by 7.8%. Even the weather can exacerbate the condition—dry and windy conditions are particularly apt to trigger the ocular misery. I'm not suggesting that we found a steady-state in terms of the balance between virtual work and work in the office, but there are some efficiencies that are being realized that I think will actually sustain long term as we move forward. And last but not least, I'd like to do a -- just a shout-out for the partnership and collaboration that we've seen not only within industry and across industry but also with regulators around the world. 3 ranking across all industries on its annual 2020 supply chain top 25 index. The fact that we've been able not just to weather this crisis but bring our broad-based capabilities to support this crisis and deliver on our shorter-term top and bottom-line business goals while increasing our investments in innovation at record levels is a remarkable testament to our purpose-driven culture and core strengths that characterize our company for over a century: execution, innovation, and people. All contents © Copyright Johnson & Johnson Services, Inc.1997-2020. Danielle Antalffy -- SVB Leerink -- Analyst. And, Louise, I might just add one other point, and that is we actually look forward to working with the new administration on issues related to healthcare. That's pretty impressive given the headlines. Consistent with the statements that we made from the very beginning, we want to ensure that we've got a very robust program, not only geographically but also by ethnicity, gender, as well as a number of other different parameters, all as part of an effort to give us the best possible understanding of the efficacy and safety profile of our vaccine. So let's get into the details for full-year 2021 guidance for you to consider in updating your models. Secondly, more broadly about healthcare, I do think that -- and we do feel that COVID-19 has had a very profound effect on healthcare systems, both near term and short -- and longer term. In 2020, we filed submissions in the U.S. and EU for paliperidone palmitate 6-month formulation for the treatment of adults diagnosed with schizophrenia. Pharmaceutical margins improved by 200 basis points to 42%, driven by favorable product mix and sales, marketing, and administrative expense leveraging. Joining me on today's call are Alex Gorsky, chairman of the board of directors and chief executive officer; and Joe Wolk, executive vice president, chief financial officer. This improvement is due to both improvement in the cataract and refractive markets, as well as new products like TECNIS Toric II IOL for astigmatism. Some of that's Medical Device recovery. And then in Vision Care, there are a couple of different pushes and pulls going on, both in contact lenses, as well as in vision surgery. And we do view our growth is still competitive versus the market. Adjusting for that, contact lens did grow. This adjusted operational sales growth is on a constant-currency basis, reflecting how we manage our business performance. Our disciplined, long-term focus yields a financial strength that affords us the ability to quickly act to address the COVID-19 pandemic in many ways, most notably on our ongoing vaccine development, but to also continue investing in innovative solutions to better the future of healthcare, even when short-term uncertainty exists. And finally, we are powered by our people, purpose, and value system. We believe nipocalimab encompasses a pipeline and a product opportunity that can treat a broad range of devastating autoantibody-driven diseases. Get expert information about symptoms, the latest treatments and how to find a doctor in your area. If you look at where we landed, we basically landed at the low end of that range given some of the additional softness that the market experienced in the December time frame where procedures were probably down more around that 10% range. Alex stated on this call and really throughout 2020 that Johnson & Johnson is built for times like this. And by the way, we think the outlook for that longer term, given some of the pent-up demand that we're likely to see, will be quite significant. Worldwide trauma delivered growth of 3.6% globally. It's, I think, 24 different administrations from both Republican and Democrat. Appreciate the questions. Let me spend a few minutes providing some qualitative context about 2021, although not intended to specifically provide segment or quarterly guidance. Knees declined 13.9% globally as we continue to see procedures in this space highly impacted by COVID-19, especially revision procedures where we have a higher share than primary. Thanks, Danielle. We did benefit by having our fiscal year-end lapse into 2021, as Chris noted, and we are now planning for a payment related to the anticipated final opioid litigation agreement in principle in 2021 versus the previous planned 2020 payment. And so as, hopefully, we see improving trends with the virus in Europe over the course of 2021, we would expect to see that return. In Q4, COVID-19 cases and hospitalizations reached their highest levels in certain parts of the world while cases remained relatively stable in others. Thank you very much, everybody. And if I look at our pharmaceutical portfolio, the great performance that they delivered in 2020 was once again met with, for the fourth consecutive year, price decreases overall in the portfolio. Race Director Dave McGillivray looks on from the platform at the start of the 2017 Boston Marathon in Hopkinton, Mass. Thank you. In the U.S., OTC sales were flat, and the OUS declined by 2.9%. We think it can enhance the surgeon's ability to really personalize total knee arthroscopy. Our Consumer Health business also performed above market for the year, and our Medical Devices business demonstrated resiliency and agility, leading to a strong second-half recovery. So those are some of the factors that are going into our bullish call of above 200 basis points margin improvement. In the fourth quarter of 2020, our adjusted income before tax for the enterprise as a percentage of sales decreased from 27.1% to 24.9%, primarily driven by the COVID-19 impact this quarter. So it's somewhat of a fluid situation. But overall, we're seeing hospital volumes decrease no more than about 10% or 15% in areas such -- for example, in the U.K., a couple of other places in Europe. And again, assuming much-improved vaccine distribution, better overall control of COVID-19, we would then expect to see volumes come back to more normalized levels as we finish the year. As discussed on our third-quarter earnings call in October, we acquired Momenta Pharmaceuticals and a lead therapeutic candidate, nipocalimab, which is in Phase 2 and Phase 3 clinical development for the treatment of rare autoantibody-driven diseases. Ellen Kullman — CEO and Chairman of DuPont 71. I was wondering if you could give us a sense to what happened to device growth maybe in the United States in Q4 relative to Q3, again, net of those one-timers. Hey, Bob, thank you very much. And do we see that in the back half of the year? This slide illustrates the components of our 2021 EPS guidance. Global wound closure grew by 1.5% through the strength of STRATAFIX barbed suture and PRINEO topical skin adhesive products in both the U.S. and OUS markets. Advanced surgery returned to growth with a 2% increase versus prior year, led by strong performance in U.S. biosurgery, which grew 12.1% in the quarter.